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Home My WebLink AboutBLDE-20-000988 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-000988 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:8/22/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice othis or her intention to pertorm the electnca►work described below. Location(Street&Number) 135 SOUTH SHORE DR UNIT Owner or Tenant MILLER JOHN LEE SR Telephone No. Owner's Address MILLER NANCY LEE,8912 SEVEN LOCKS RD, BETHESDA, MD 20817-2056 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Repairs to receptacle 4 Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Siens Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Joseph P Pignolet Licensee: Joseph P Pignolet Signature LIC.NO.: 20170 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 153 SANDWICH RD,TEATICKET MA 025365603 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$80.00 Ot L 31Z'e(( °! £- Commoruuealth of///a kuzetts Official Use • -i n Y' f.tc�ire Jerviced Permit No:E2.0--• sdi,ge ,,,!f-i f.' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked -..._ [Rev. 1/07] (leave blank) �i —_-----1Z '• PPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK \eiLU 1� F All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12A0 �'" �; cf i iP •SE PRINT IN INK OR TYPE ALL INFORMATION) Date: a w I Cityor Town of: � 111YARMOUTH To the Inspector of Wires: o _ I�y ...s application the undersigned gives notice of his or her intention to perform the ele ical work described below. Ao•. Lion (Street&Number) I�j- 50 f-t-i 1 3 ,r � i' (A-Li 0,r 3 0 �R i W 1 l9!wHer or Tenant 5 v --)i •C)`f c-0 f 7 q e� Telephone No. j_ Owner's Address I S 5 co t.,C1 )-f ,5 He re_ Is this permit in conjunction with a bonding permit? Yes ❑ No . ❑ (Check Appropriate Box) Purpose of Building t:OM Wt*v1c t' / Utility Authorization No. Existing Service 9.) Amps tXV/ 4t1)Volts Overhead [Undgrd❑ No.of Meters j New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: f c- ,._L9 c c_- ; L I .7- 't..-aTft-f I & r`C .1 r !.2' -' - Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceal.�usp.(Paddle)Fans No.of Tom Transformers KVA _ No. of Lnminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above In- No.of Emergency Lighting gErn& ❑ arnd. ❑ Battery units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners • No.of Detection and Initiating_Devices Toial No.of Ranges No. of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number(Tons I KW 'No.of Self-Contained Totals: i Detection/Alerting Devices r5 No.of Dishwashers Space/Area Heatin KW' Municipal " g Low Connection ❑ Other No,of Dryers Heating Appliances KW Security Systems:* �' No.of Water No.of Devices or Equivalent i No.of Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromass age Bathtubs No.of Motors Total HP TelecommunicationsofDeiceor Wiring: OTHER: No.of Devices Equivalent Attach additional detail if desired or as required by the Inspector of Wires. d Estimated Value of Electrical Work (When required by municipal policy.) 4) Work to Start Inspections to be requested in accordance with MEC Rule 10,and upon completion. '- INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The �. undersigned certifies that such c,.o,_v,ers�sin force,and has exhibited proof of same to the permit issuing office. .,) CHECK ONE: INSURANCE C(�BOND 0 OTHER 0 (Specify:) i)J I cent)", under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: �p�r,. 1t iT . . }� �I l . t I.t i & ( e_� P'`t lf,. - yL /LIC.NO.: 1,1/0 ,,eF Licensee: ,c cc,eP ,9. p;` w'tr` i Signature (If applicable.enter"es t"in the license number line.) LIC.NO.: t^l fJ 1 /'1. Address: / ''3 vrA- t`exi- 0 ( r E f� 'AO tc.i I/ A —Als.TeL No.:_ '7 ti �1 '`1't ,l *Per M.G.L. c. 147,s.57-61,securitywork requiresL t.TeL No.: Department of Public Safety"S"License: Lic.No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n— ormally S required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner Elowner's agent. Owner/Agent ' Signature: Telephone No. PERMIT FEE: $ U